What is Chronic Myeloid Leukemia?
Ongoing research in targeted therapy, immunotherapy, and gene therapy offers promise for even better outcomes in CML management. Some patients in long-term remission may eventually be able to reduce or stop TKI therapy under close medical supervision.
CML symptoms vary depending on the phase, and many people in the chronic phase experience few or no symptoms. As the disease progresses, however, symptoms may include:
Fatigue and Weakness: Common due to anemia or the energy demands of increased cell production.
Weight Loss: Unexplained weight loss and reduced appetite are often experienced.
Abdominal Discomfort: Swelling in the upper abdomen, caused by an enlarged spleen, can lead to a feeling of fullness even after small meals.
Night Sweats: Patients may experience excessive sweating at night.
Frequent Infections and Bruising: As healthy blood cells decrease, susceptibility to infections increases, along with a tendency to bruise easily.
Bone Pain: Pain in bones or joints may occur, especially in the advanced stages.
CML diagnosis involves a combination of blood tests, bone marrow tests, and genetic testing:
Complete Blood Count (CBC): Elevated white blood cell counts often indicate CML, sometimes alongside low red blood cell and platelet counts.
Bone Marrow Biopsy: A biopsy examines the bone marrow to confirm the presence of leukemia cells and assess the phase of CML.
Cytogenetic Testing: Tests like fluorescence in situ hybridization (FISH) detect the Philadelphia chromosome and the BCR-ABL gene, confirming CML.
Quantitative Polymerase
Chain Reaction (qPCR): This sensitive test measures the level of BCR-ABL gene in the blood, essential for monitoring treatment response.
Treatment for CML has advanced significantly, especially with the introduction of targeted therapies. Key treatment approaches include:
Targeted Therapy: Tyrosine kinase inhibitors (TKIs), such as imatinib, dasatinib, nilotinib, and bosutinib, block the BCR-ABL protein, which promotes cancer cell growth. TKIs are the first-line treatment for CML and are effective in managing the disease in the chronic phase.
Stem Cell Transplant (Bone Marrow Transplant): For younger patients or those who do not respond to TKIs, a stem cell transplant may be an option. This procedure replaces diseased bone marrow with healthy cells from a compatible donor.
Chemotherapy: In cases where TKIs are ineffective, chemotherapy drugs may be used to control the growth of leukemia cells. However, chemotherapy is generally less effective than targeted therapy in CML.
Interferon Therapy: This therapy uses a protein that helps the immune system fight cancer cells. Interferon may be used when TKIs are not suitable or as part of clinical trials.
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